Consider the following patient scenario:

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). 

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

 

Topic 2 DQ 2

The difference in culture, origin, and worldviews significantly affects how healthcare professionals handle various patients. Consequently, while working with Sister Mary, a healthcare professional’s possible reservations could have included spirituality, social beliefs, and religious beliefs. Spirituality is the connection between human beings and supernatural beings, essential in patients’ lives. Nonetheless, most health providers do not talk about religious beliefs and spirituality during patient education due to various reasons, such as poor communication, psychosocial factors, and time limits (Henderson et al., 2018). When caring for Sister Mary, healthcare providers must recognize their own biases, try to focus on their care, and not on assumptions or judgments. The most important step in reducing prejudice is acknowledging that it exists and working on being mindful of those attitudes when providing care (Narayan, 2019). A health professional should remain respectful and culturally competent; thus, a health professional should desist from discrimination and judging a patient by appearance, dialect, spiritual inclination, degree of illness, and behavior.

Cultural competence is essential in providing quality and patient-centered care; therefore, while working with Sister Mary, a health provider should make reservations that do not contradict her social beliefs. In a clinical setting, health providers come across patients, such as Sister Mary, who have varied beliefs and cultures; thus, a health professional should reserve their ideas to learn and understand Mary’s religious and cultural beliefs (Lin et al., 2017). Moreover, other reservations a health professional could make include offering compassion and love to Sister Mary, irrespective of the differences in their cultural and social beliefs. Reservations in health care allow healthcare professionals to tailor-make the treatment process to suit every patient; thus, it requires critical thinking, justice, beneficence, and nonmaleficence.

 What possible reservations could a health care professional have in working with Sister Mary? (Discuss the psychosocial responses the professional might have.) 

  

Using 200-300 words APA format with at least two references. Sources must be published within the last 5 years

 

Course Project Part 1—Gap Analysis Plan and Visio Draft

 

 

 

The process of comparing the current state of a system or workflow and to the desired, future state of the workflow, and then formulating preliminary ideas about how to move from the current to the future is known as a gap analysis. There are several different ways to collect information about an identified problem and potential solution, including observations, interviews, oral surveys, questionnaires, and existing data, tests.

 

 

 

 

 

This week you will begin crafting a Gap Analysis Plan to acquire information about a specific workflow issue in your organization or in one with which you are familiar.

 

Note: Your workflow issue MUST be related to the implementation or optimization of electronic health records (EHRs) in the organization in order to connect to meaningful use and the HITECH Act. If the organization currently uses an EHR system, your workflow issue should be related to an inefficiency or problem with how the EHR system is used. If the organization does not yet have an EHR system, your workflow issue should be related to an inefficiency or problem that could be solved by implementing an EHR system.

 

 

 

 

 

To prepare for Part 1 of the Course Project:

 

• Identify the workflow issue you would like to explore throughout your Course Project. This should be a specific task about which you have sufficient content knowledge and access to describe and analyze in detail. Your workflow issue MUST be related to EHRs and be significantly tied to one or more meaningful use objectives. The workflow issue may be related to either the optimization of an existing EHR system or the implementation of an entirely new EHR system.

• Establish your goals for conducting your gap analysis. These goals describe why you are conducting the gap analysis, the workflow issue you are pinpointing, and what you hope to accomplish in examining this issue.

• Determine how you will collect data about the current workflow you are exploring for the Course Project. For example, you may choose to observe people as they move through the workflow, ask people about their experiences, confer with managers and leaders about their involvement, refer to your organization’s training manual or other informative documents, etc. Be sure to use more than one data-collection method and observe or consult with more than one person to ensure that the information you gather is balanced.

  Note: If you are not currently working in a health care organization, you must locate an organization in your area and obtain informal permission to speak with and observe individuals. Consult your Instructor if you have questions on how to proceed.

   

 

• Participate in the Week 4 Discussion and review the comments made by your colleagues and the Instructor on your preliminary workflow issue. Revise your workflow issue and data-collection methods as appropriate.

• After you have revised your workflow issue, begin composing your Gap Analysis Plan paper using the requirements outlined below

• As you write your paper, begin drafting the current-state workflow based on your preliminary knowledge (no outside information needed) in Visio. Include a swimlane showing, to the best of your knowledge, who is responsible for each step in the workflow. Use standard modeling symbols for workflow depicted in the Dennis, Wixom, and Roth text and the “Workflow Assessment for Health IT Toolkit” in the Week 4 Learning Resources.

  Note:The primary purpose of the draft is to ensure that you are comfortable working with Visio. At this point, no outside sources are needed; your draft should be based only on your preliminary knowledge about the workflow. This exercise is mainly for practice, so your draft should be simple rather than detailed at this stage. In Week 6, you and your colleagues will conduct a peer review of one another’s workflow drafts. You will use the feedback you receive to revise and refine your draft before your first formal Visio deliverable is due in Week 7.

   

   

  To complete Part 1 of the Course Project:

   

 

1.      Write a 3- to 4-page Gap Analysis Plan that addresses the following:

 

• Identify the workflow issue you will be exploring in the Course Project (Incomplete Medication Reconciliation, see attached file). Explain how this workflow issue is tied to EHRs. Identify the specific meaningful use objective(s) related to the workflow issue.
• List 3 goals you have set for your gap analysis and what you hope to accomplish by examining the workflow you selected.
• Describe your methods of data collection and the individuals you will observe, consult, and/or interview. Include any relevant narrative statements, checklists, interview questions, or other tools you will use to collect data.
• Explain how you will minimize disruption in the workflow during observations and how you will avoid bias as you conduct your gap analysis.
• Describe how you will record, quantify, and analyze the data you collect. Explain how you will establish baseline metrics to normalize data from different sources of information.

 

2.      In a reference list, cite a minimum of four scholarly references (with APA citations) that you used to create your Gap Analysis Plan.

 

3.      Post a draft of your current-state workflow in Visio. Your Visio draft should include your preliminary knowledge about the primary steps and activities within your workflow. In addition, include a swimlane showing who is responsible for each step, and use the appropriate diagramming symbols within your Visio draft.

 

 

 

 

 

Required Readings

 

 

 

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

 

• Chapter 15, “The Electronic Health Record and Clinical Informatics”

   

  This chapter explores the components of electronic health records and explains their significance in patient care. The authors evaluate the political facets of implementing these records and project how their implementation will benefit health care as a whole.

   

  Dennis, A., Wixom, B. H., & Roth, R. M. (2015). Systems analysis and design (6th ed.). Hoboken, NJ: Wiley.

 

• Chapter 3, “Requirements Determination” (pp. 81–115)

   

   Adherence to business requirements is important during a project. It is integral to plan the project with said requirements in mind. In this chapter, the authors demonstrate the processes of familiarizing one’s self with requirements and implementing them in the project plan.

   

  Helmers, S. (2011). Microsoft Visio 2010 step by step. Sebastopol, CA: O’Reilly.

 

• Chaper 1, “A Visual Orientation to a Visual Product” (pp. 1–36)

   

  This introductory chapter walks the user through the basic desktop and tools necessary to get started in using Microsoft Visio. It provides instructions on the Visio ribbon, explores the drawing window, and offers tips on using and manipulating the variety of shapes available.

   

• Chapter 2, “Creating a New Drawing” (pp. 37–68)

   

  This chapter outlines the steps necessary for actually creating a drawing, and covers such topics as selecting the correct shape, connecting shapes, and using the Auto features.

   

  Bayer, S., Petsoulas, C., Cox, B., Honeyman, A., & Barlow, J. (2010). Facilitating stroke care planning through simulation modelling. Health Informatics Journal, 16(2), 129–143.

  Retrieved from the Walden Library databases.

   This article provides an example of how workflow can be used to improve the level of health care being provided. In this particular case, data analysis and modeling were used to determine the optimal workflow for dealing with stroke patients.

  Campbell, E. M, Guappone, K. P., Sittig, D. F., Dykstra, R. H., & Ash, J. S. (2009). Computerized provider order entry adoption: Implications for clinical workflow. Journal of General Internal Medicine, 24(1), 21–26.

  Retrieved from the Walden Library databases.

   This article assesses the impact of computerized provider order entry (CPOE) on clinical workflow. The mass adoption of advanced data capture and access methods can effect change in both positive and negative ways, so care needs to be taken in the design phase to provide a user friendly system.

   

  Crosson, J. C., Etz, R. S., Wu, S., Straus, S. G., Eisenman, D., & Bell, D. S. (2011). Meaningful use of electronic prescribing in 5 exemplar primary care practices. Annals of Family Medicine, 9(5), 392–397.

  Retrieved from the Walden Library databases.

   One benefit of the widespread use of electronic health records (EHRs) is the opportunity to have electronic prescription capabilities. This article suggests practices that will help ensure e-prescribing that is high quality, efficient, and safe.

   

  Effken, J. A., & Carrington, J. (2011). Communication and the electronic health record: Challenges to achieving the meaningful use standard. Online Journal of Nursing Informatics, 15(2).

  Retrieved from the Walden Library databases.

   Transitioning into a heavier use of health IT requires the adoption of more effective means of applying and deriving meaning from the data available. This article addresses the optimal relationship between user/IT communication and proper use of EHRs for achieving high-quality patient care.

   

  Agency for Healthcare Research and Quality. (n.d.). Workflow assessment for health IT toolkit. Retrieved October 22, 2012, from http://healthit.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit

   This web page provides a number of resources that examine how to plan, design, implement, and use workflows and how to analyze current systems to ensure optimum workflow.

   

 

Optional Resources

 

 

 

There are a wide variety of online tutorials available to assist you with using Visio. Below are two you might consider, as needed:

 

 

 

Microsoft. (2011). The Visio 2010 MVP sessions. Retrieved from http://office.microsoft.com/en-us/visio/

 

 This free resource, developed by Microsoft, provides video tutorials in the use of all aspects of Visio 2010.

 

 

 

Edson, D. (2011). Visio 2010 essential training. Retrieved from http://www.lynda.com/Visio-2010-tutorials/Essential-Training/75921-2.html

 

 This series of videos provides detailed instruction on all aspects of Visio use. This resource requires a paid subscription.

 

 

 

 

 

 

 

Philosophy and Science in a Practice Discipline

A nurse enters a patient’s room to check her vitals and spends some time talking with the patient’s family how they are doing.

Later that day, another nurse responds to the patient’s call button; she becomes concerned when she discovers that the patient is running a fever and is in pain despite receiving the medication that has been ordered for her. She recalls a similar instance with a different patient, and keeps that in mind as she asks the patient about how she is feeling.

These seemingly simple actions are guided by philosophy—each nurse’s view of nursing and appropriate patient care.

Do you, personally, think nursing should rely solely on biological science? Or do you think it is important for nursing to incorporate a broader, more holistic approach to care? How do you know what you know? What sources of information are most significant to you? How should you determine what types of research are applicable to nursing practice?

To prepare:

• Reflect on your professional experiences, and assess how philosophy and science influences nursing practice.

• Consider how the scientific method is supported by philosophy, and how it influences nursing knowledge.

 

By tomorrow 5/31/17, post 550 words essay in APA format with 3 references from the list below, that include the level one heading as numbered below:

post a cohesive response that addresses the following:

1)       Why are philosophy and science important to a practice discipline?

2)       How do they legitimize the nursing profession?

3)       Provide examples from your nursing practice that demonstrate how the scientific method influences nursing knowledge.

 

 

Required Readings

 

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

Chapter 1, “Philosophy, Science, and Nursing”

 Chapter 1 introduces the scientific and philosophical foundations of nursing and how these contribute to knowledge development within the discipline of nursing.

 

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 1, “Discovering the World of Nursing Research”

 Chapter 1 introduces nursing research and discusses how science, theory, and philosophy all influence research.

Chapter 2, “Evolution of Research in Building Evidence-Based Nursing Practice”

 Chapter 2 reviews the history of nursing research beginning with the work of Florence Nightingale and examines the influence of nursing research today on evidence-based practice.

 

 

Moran, K., Burson, R., & Conrad, D. (2017). The doctor of nursing practice scholarly project: A framework for success (2nd ed.). Burlington, MA: Jones & Bartlett Learning.

Chapter 1, “Setting the Stage for the Doctor of Nursing Practice Scholarly Project”

Chapter 5, “The phenomenon of Interest”

Chapter 6, “Developing the Scholarly Project”

 

Isaacs, S., Ploeg, J., & Tompkins C. (2009). How can Rorty help nursing science in the development of a philosophical ‘foundation’? Nursing Philosophy, 10(2), 81-90. doi:10.1111/j.1466-769X.2008.00364.x

 

Note: You will access this article from the Walden Library databases.

This article discusses the application of the Richard Rorty’s pragmatic philosophy to nursing practices and research.

 

Kinsella, E. A. (2010). Professional knowledge and the epistemology of reflective practice. Nursing Philosophy, 11(1), 3-14. doi:10.1111/j.1466-769X.2009.00428.x

 Note: You will access this article from the Walden Library databases.

 This article examines the philosophical underpinnings and epistemological assumptions of reflective practice in an effort to advance understanding for application in professional healthcare settings.

 

Mackay, M. (2009). Why nursing has not embraced the clinician-scientist role. Nursing Philosophy, 10(4), 287-296. doi:10.1111/j.1466-769X.2009.00416.x

 Note: You will access this article from the Walden Library databases.

 In this article, the role of the clinician-scientist and importance of clinical research for nursing is examined.

 

Persson, J. (2010). Misconceptions of positivism and five unnecessary science theoretic mistakes they bring in their train. International Journal of Nursing Studies, 47(5), 651-661. doi:10.1016/j.ijnurstu.2009.12.009

 Note: You will access this article from the Walden Library databases.

 This article discusses misconceptions of positivism and the implications of these misconceptions for nursing researchers.

 

Pesut, B., & Johnson, J. (2008). Reinstating the ‘Queen’: Understanding philosophical inquiry in nursing. Journal of Advanced Nursing, 61(1), 115-121. doi: 10.1111/j.1365 -2648.2007.04493.x

 Note: You will access this article from the Walden Library databases.

 This article provides an analysis of the use of philosophical inquiry within nursing research. The article identifies characteristics of philosophical inquiry as well as common tools used in this methodology.

 

Porter, S. (2001). Nightingale’s realist philosophy of science. Nursing Philosophy, 2(1), 14-25. doi:10.1046/j.1466-769X.2001.00029.x

Note: You will access this article from the Walden Library databases.

 In this article, Florence Nightingale’s realist philosophy of science is compared to today’s dominant philosophy of positivism.

 

Optional Resources

 

Connor, M.J. (2004). The practical discourse in philosophy and nursing: An exploration of linkages and shifts in the evolution of praxis. Nursing Philosophy, 5(1), 54-66. doi:10.1111/j.1466-769X.2004.00159.x

 Note: You will access this article from the Walden Library databases.

 

Chou, M., & Lee, L. (2007). Initial formation of nursing philosophies following fundamental clinical practice: The experience of male nursing students. Journal of Nursing Research, 15(2), 127-137.

 Note: You will access this article from the Walden Library databases.

 

Effken, J. (2007). The informational basis for nursing intuition: Philosophical underpinnings. Nursing Philosophy, 8(3), 187-200.

 Note: You will access this article from the Walden Library databases.

 

Mantzoukas, S., & Jasper, M. (2008). Types of nursing knowledge used to guide care of hospitalized patients. Journal of Advanced Nursing, 62(3), 318-326. doi: 10.1111/j.1365-2648.2007.04587.x

 Note: You will access this article from the Walden Library databases.

 

Mills, J., Chapman, Y., Bonner, A., & Francis, K. (2007). Grounded theory: A methodological spiral from positivism to postmodernism. Journal of Advanced Nursing, 58(1), 72-79. doi: 10.1111/j.1365-2648.2007.04228.x

 Note: You will access this article from the Walden Library databases.

 

Persson, J., & Sahlin, N. (2008). A philosophical account of interventions and causal representation in nursing research. International Journal of Nursing Studies, 46(4), 547-556. doi: 10.1016/j.ijnurstu.2008.11.008

 Note: You will access this article from the Walden Library databases.

 

 Trochim, W. (2006). Research methods knowledge base: Positivism & post-positivism. Retrieved from http://www.socialresearchmethods.net/kb/positvsm.php